Wu, a 54-year-old retiree from China’s southwestern Sichuan province, was struggling to get antiretroviral medication when her 92-year-old mother contracted Covid-19 this month.
“By the time I found out my mother had Covid, it had been two days since she had eaten anything,” she said.
Relatives in Shanghai rushed to send antiretroviral drugs by mail after local hospitals and clinics ran out of supplies, but when the drugs arrived, Wu’s mother tested negative.
Drug shortages hit hospitals in Beijing and Shanghai last month Covid Rising cases are now expanding to rural areas due to inefficient bureaucracy, price disputes with pharmaceutical companies and overspending on testing capacity which has resulted in a shortage of resources.
Despite pledges by Pfizer, the maker of the antiviral drug Paxlovid, to build a factory in China In the coming months, there is no indication that the drug will be permanently approved for the country’s national health insurance scheme. This puts it out of reach for many Chinese.
The annual migration of urban workers to their hometowns in poorer provinces is expected to accelerate the spread of Covid to remote areas, increasing the risk of more severe outbreaks. Last week, President Xi Jinping warned that the pandemic was Entering a “new phase” and that he is now “mainly interested in rural areas and rural inhabitants”.
A doctor at a district hospital in Sichuan told the Financial Times that the facility did not have antiretroviral drugs. covid medicine to treat a large number of patients. Practitioners have instead relied on fever-reducing medications to care for Covid patients until last week.
This echoes complaints from medical experts in Beijing last month, where hospitals ran out of beds, oxygen and medicine after Chinese authorities abandoned their policy to contain Covid-19.
When the hospital in Sichuan finally received four boxes of Paxlovid and Azvudine, a domestic Chinese antiviral drug, last week, the doctor said regulatory hurdles had prevented staff from prescribing easy menu. Because of the scarcity, hospitals have to get permission from local authorities for each prescription. “It’s troublesome,” said the doctor.
In remote areas, lack of antigen testing and lack of access to lung imaging equipment also hinder early diagnosis, allowing the virus to spread.
“More effort is needed to distribute drugs to remote areas,” said Helen Chen, larger China managing partner at LEK Consulting in Shanghai, adding that cities tend to towards narrowing the supply of on-demand drugs before rural areas have access to them.
China licensed Paxlovid under regulation in February 2022, making it the first foreign Covid treatment to enter the mainland market. But the National Health Security Administration, the agency that negotiates drug prices for China’s national health insurance reimbursement program, balked at the “high price” charged by Pfizer.
The NHSA released an unusual statement saying negotiations had failed over pricing. Chen said the government may have “broken their silence” to “signal to the public that they have made an effort” but that “providing the product at a price the government deems reasonable” is depending on Pfizer.
Pfizer said it will build a factory in China to manufacture Paxlovid with a local partner, but the US pharmaceutical giant hinted it would be unlikely to lower the price of the drug – a condition for its permanent inclusion in the national reimbursement program. It also excludes licensing a generic version for the Chinese market.
“They’re the second-highest economy in the world,” Pfizer chief executive Albert Bourla said at a conference in San Francisco this month. “I don’t think they should pay less than El Salvador.”
Under the terms of the emergency settlement, Paxlovid is eligible for a refund until the end of March. Bruce Liu, head of life sciences for China at consulting firm Simon-Kucher & Partners, estimates the company could earn Rmb 10 billion ($1.5 billion) in revenue under the deal. . He estimates 5 million boxes of Paxlovid will be shipped to China in March, much less than demand.
Private buyers have reached out to Paxlovid, which sells for up to Rmb 8,300 at high-end hospitals. In some cases, the patient has bought it on the black marketpay up to $7,000 for lower quality drugs or similar remedies.
Meanwhile, Chinese domestic products face questions about effectiveness and safety. China’s first antiretroviral drug, Azvudine, developed by drug maker Genuine Biotech and included in the return list, was repurposed from an HIV treatment.
A study by China’s pharmaceutical regulatory agency found that the drug contained substances that damaged genetic information in cells during animal testing. “There are questions about the toxicity of this drug, a risk that is significant for AID patients but not necessarily for someone with Covid,” Liu said.
China’s inability to build solid defenses to prepare for the inevitable wave of Covid’s retreat has created a Legitimacy crisis for President Xi Jinping and his top Covid-free policy.
“They have three years to prepare for this,” said a pharmaceutical industry insider in Shanghai. “They don’t have the right vaccines or enough supplies to deal with the increase in cases.”
As cases increase across China, for Wu’s mother, the recovery from Covid has been long and painful.
She had a brain bleed, her daughter said, and there was still darkness on her chest x-ray. But because medical guidelines recommend that patients take antiviral medication within five days of being infected, they didn’t take the medicine they had.
“We wanted to use antiretroviral drugs,” Wu said, “but didn’t dare.”